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Chapter 25. Hypercapnic Respiratory Failure

Mark J Rosen, MD, FCCP
DOI: 10.1378/pulm.26.25
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Sections

Objectives 
  • Understand the determinants of Paco2 and the types of physiologic derangements that lead to hypercapnia.

  • Review specific neurologic and muscular disorders that cause respiratory failure.

  • Discuss respiratory muscle function and the assessment of respiratory muscle strength.

  • Outline the types of situations in which an imbalance between the work of breathing and energy supply to respiratory muscles leads to fatigue.

  • Discuss how hypercapnia may occur when excessive concentrations of inspired oxygen are administered to susceptible persons.

Synopsis 

This chapter will present the types of physiologic derangements that lead to hypercapnia and explore and explain the determinants of Paco2. Specific neurologic and muscular disorders that can cause respiratory failure will be reviewed, and respiratory muscle function and strength will be discussed. Excessive oxygen administration may worsen preexisting hypercapnia, particularly in patients with COPD, and the contributing mechanisms will be presented.

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